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Medical Service Representative

3 months ago

Durham, United States Select Source International Full time
Job DescriptionJob Description

Medical Service Representative

06 Months 

Remote

 

Job description:
• Process a variety of requests, inquiries and transactions via phone, email, fax, and mail

• Review requests to ensure accuracy

• Support internal & external customers via phone or email

• Document all pertinent information related to the call/inquiry, attach supporting information as applicable and if unable to resolve route to appropriate area for follow up as applicable

• Gather and analyze data to provide feedback to Team Leads on employee development needs and/or specific providers requiring education on prior approval or pre-certification process 

• Screen inquiries to determine if authorization is required

• Verify member benefits and eligibility and/or provider setup.

• Maintain and update Service Requests and research incorrect or missing information.

• Triage and assign all incoming inquiries in a timely, efficient manner throughout the day to appropriate staff

• Perform Peer Audits monthly as required

• Provide clinical review outcome notification to members and providers (verbal and written)

 Hiring Requirements

• High school diploma or GED

• 3+ years of experience in related field.

Company DescriptionSelect Source International (SSI) is an IT, Health Care, and Engineering Services consulting firm that has been in business since 1998. SSI consultants have provided exceptional services that have been appreciated by clients, customers, and users alike at several large Fortune 500 companies, mid-size enterprises, and consulting companies.Company DescriptionSelect Source International (SSI) is an IT, Health Care, and Engineering Services consulting firm that has been in business since 1998. SSI consultants have provided exceptional services that have been appreciated by clients, customers, and users alike at several large Fortune 500 companies, mid-size enterprises, and consulting companies.